Investigative Analyst, CMS Healthcare Claims

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $83.9k - $113.5k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Support the Centers for Medicare and Medicaid (CMS) • Identify trends in healthcare claims data • Create fraud, waste, and abuse leads and referrals for Healthcare Fraud Prevention Partnership members and the Trusted Third Party • Perform analytical tasks supporting the HFPP program • Conduct data mining across the partnership using internal tools • Collaborate on HFPP analytic reports • Develop referrals and leads based on HFPP analytic reports • Drive outcome metrics related to referrals and leads shared with Partners • Interact regularly with Partners regarding identified referrals and leads • Perform potential business development activities, including analyzing health claims data, generating study referrals and leads, developing provider background profiles, and identifying collaboration opportunities

🎯 Requirements

• BA/BS or equivalent experience • 8+ years of experience in health care claims analysis • Equivalent work experience may be considered in lieu of degree • Strong oral and written communication skills, with ability to present to management-level staff • Expert-level knowledge of Microsoft Office suite • Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence • Working knowledge of HIPAA privacy and security rules • Ability to identify trends in healthcare claims data • Strong decision-making, organizational, and prioritization skills • Ability to work independently and with minimal guidance on complex projects • Ability to build effective relationships and demonstrate interpersonal skills • Ability to work in team environments and independently • Work visa sponsorship will not be provided

🏖️ Benefits

• Comprehensive medical plan options, some with Health Savings Accounts • Dental plan options • Vision plan • 401(k) plan with company match • Full-flex work weeks • Paid time off, including vacation, sick, personal, holiday, parental, military, bereavement, and jury duty leave • Typically 15 days of paid leave per calendar year • 10 paid holidays per year • Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees • Short- and long-term disability benefits • Life insurance • Accidental death and dismemberment insurance • Personal accident insurance • Critical illness insurance • Business travel and accident insurance • AI-powered career tool identifying career steps and learning opportunities • Internal mobility team • Award-winning culture of innovation • Military-friendly workplace